Provider Demographics
NPI:1164168399
Name:GREGORY, PAULA BRENDA (PERSONAL CARE AIDE)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:BRENDA
Last Name:GREGORY
Suffix:
Gender:F
Credentials:PERSONAL CARE AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 BLISSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-5043
Mailing Address - Country:US
Mailing Address - Phone:440-749-3494
Mailing Address - Fax:
Practice Address - Street 1:30707 LAKE SHORE BLVD APT 206
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-3669
Practice Address - Country:US
Practice Address - Phone:440-477-4264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide